Nursing home - pvt room - Medicaid?

Kay7979

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To those of you who were so kind to respond previously to my issue about my bed ridden mother not wanting to go to a nursing home, I'm starting to have a break through, and I think I will be able to get her to go. She has an insurance policy that will pay for 1 year in a nursing home, then she is on her own and would have to go on Medicaid or Medicare, and since she has no assets aside from maybe 600-700 SS income and a couple hundred in her checking account at any time, she would definitely qualify for Medicaid.

I told her it might be possible for her to have a private room, since sharing a room with someone else was a pretty scary thought for her. When I checked out the most likely nursing home in my little city of about 20,000, the social worker there said they had very few private rooms, and she told me that putting my mother in a private room in a Medicaid facility was very unlikely. I can check a few other places, but I don't have many options unless I want to place her 30-45 minutes away from me in a bigger city rather than 10 minutes away.

Do any of you know whether private rooms are typically only available at the more costly private pay type facilities?

Thanks for your help!
 
Typically private rooms go to those who medically need them such as pts who have who need isolation due to contagious disease or draining wounds.
 
My FIL recently had a stroke and is in a rehab/nursing home at the moment because he is unable to walk, or feed him himself and has alzheimers. For a little while at first, Medicare covered it, although we also wanted a private room for him...we ended up paying a certain amount per day for his private room. Now that Medicare isnt helping anymore, the amount per day has gone up. I'm not too sure about Medicaid but with the health system as it is, I would doubt they would cover a private room. Most likely that would have to be covered out of pocket. Good luck, I know this is a tough time.
 

I highly doubt any nursing home would give a PT a private room if Medicare/Medicaid is paying. MCare/MCaid does not usually pay the full price. They set the amount they will pay depending on where you live.
 
Medicare/Medicaid won't pay for a private room unless it is a medical necessity. Is it possible to put her in a room with someone she knows? If not, talk to the SW at the nursing home and try to find someone compatible with your mother. In my experience, they usually like having a room-mate once they get use to it.
 
Here is my Ny experience with my grandma. You could put her in the private room if that insurance policy paid for it. Otherwise for medicaid no, my grandma was in a small nursing home too and there was only one private room I saw, went to a very rich nasty lady with no family. You must be your mom's advocate. The first roomate my grandma didnt like and I requested a room change. The ladys family was also very loud and rude when they visited, taking our chair etc. I then went to look for other room mates for her and talked to them, one stayed up too late etc. I finally had her with a korean lady who spoke very little english but was also a little on the rude side as far as staying on your own side of the room etc. Also her family didnt come much so it kept the noise level down and my grandma got the window bed that she wanted etc. It could take some doing if the place is filled up. I also chose the place closest to my home and it was only a miracle of god and praying from my church that got her in there. They usually have no openings. Also helped that it ws winter and pneumonia spread like wildfire. God luck and always be your moms advocate etc.
 
I work with older population and in nursing homes. My experience has been Pvt. rooms usually go to Pvt. pay pts before they would go to a medicare/medicaid pt.
 












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